Impulsivityis a key symptom across many mental health conditions,particularly ADHD, where it can manifest as difficulty controlling behaviors, resisting urges, and considering consequences.
Impulsivity can lead to significant functional impairments, risky decision-making, and strained relationships.
By cultivating greater attention to thoughts, emotions, and behavioral urges, mindfulness can create a space between impulse and action, allowing for more conscious choice.
As a transdiagnostic symptom, targeted mindfulness interventions for impulsivity could potentially improve outcomes across a range of conditions.
Key Points
Rationale
Impulsivity is a transdiagnostic trait that contributes to problem behaviors and psychological symptoms across the lifespan and in many domains of life (Beauchaine & Neuhaus, 2008).
It is included in diagnostic criteria for multiple disorders in the DSM-5-TR, including ADHD, substance use disorders, bipolar disorder, and personality disorders (American Psychiatric Association, 2022).
Prevalence rates indicate impulsivity affects a substantial portion of the population, with estimates of 7% in children and 17% in adults (Palili et al., 2011; Chamorro et al., 2012).
Psychotherapies have traditionally addressed impulsivity indirectly as part of treatment for broader psychopathology. Some therapies incorporate mindfulness to target impulsivity (e.g.,DBT; Linehan, 1987).
However, the independent efficacy of mindfulness as a stand-alone treatment for impulsivity is unclear. Given that mindfulness and impulsivity seem to reflect opposite ends of a continuum in terms of awareness and response inhibition (Murphy & Mackillop, 2012), mindfulness skills alone may be sufficient to reduce impulsivity.
Parsing the unique impact of mindfulness will broaden understanding of its therapeutic value and guide future treatment development.
Method
Qualitative Metasynthesis
The authors conducted electronic literature searches in APA PsycArticles, APA PsycInfo, Google Scholar, and PubMed databases to identify peer-reviewed articles on the effectiveness of mindfulness-only interventions for reducing impulsivity.
Search terms included variations of “mindfulness” and “impulsivity.” Articles were limited to those published in English between 1985-2021.
159 abstracts were screened, and 40 full-text articles were assessed for eligibility based on inclusion criteria of 1) explicit investigation of mindfulness intervention impact on impulsivity outcomes, 2) use of an adequately developed and described mindfulness intervention, and 3) inclusion of valid and reliable impulsivity outcome measures.
Studies were excluded if they examined mindfulness or impulsivity only as a mediator/moderator, combined mindfulness with other well-defined treatment protocols, inappropriately labeled the intervention as mindfulness, or measured impulsivity-adjacent constructs like urges.
15 articles met inclusion criteria for the qualitative review.
The authors also conducted a risk of bias assessment for each included study based on Orwin’s (1994) guidelines.
Studies were evaluated on 10 criteria related to study intent, inclusion criteria, randomization, blinding, intervention standardization, outcome measures, statistical analyses, dropout rates, intent-to-treat analyses, and appropriate conclusions.
Search strategy and terms:
Inclusion and exclusion criteria:
Statistical measures
Results
This qualitative review of 15 studies found mixed evidence for the effectiveness of mindfulness interventions in reducing impulsivity. Ten studies reported significant reductions in impulsivity following mindfulness training, while five found no significant effects.
In non-clinical student and community samples, three out of five studies showed mindfulness to be effective, with the most promising results from multi-week group interventions. Two studies found no significant changes, possibly due to low baseline impulsivity or lack of control group differences.
Among incarcerated populations, two out of three studies supported mindfulness for reducing impulsivity, with benefits seen from both long-term meditation practice and structured MBSR programs. One study found no effects but had significant methodological limitations.
Clinical populations showed the most consistent benefits, with four out of six studies reporting mindfulness-related reductions in impulsivity across various diagnoses (e.g., opiate-use disorder, borderline personality disorder, ADHD). However, two studies with adolescent clinical samples found no significant mindfulness-specific effects.
The heterogeneity of mindfulness protocols, control conditions, and impulsivity measures across studies makes direct comparisons challenging.
More high-quality randomized controlled trials with standardized designs are needed to clarify the specific contexts and populations for which mindfulness is most effective as a standalone treatment for impulsivity.
Insight
This review provides preliminary indications that stand-alone mindfulness treatments may reduce impulsivity, with 10 of 15 studies finding positive effects.
However, the highly variable nature of the studies in terms of populations, mindfulness protocols, control groups, and outcome measures makes it difficult to draw firm conclusions.
There is a clear need for greater standardization and methodological rigor in this research area moving forward.
The fact that some studies found mindfulness no more effective than alternative treatments suggests its unique impact needs to be parsed out more carefully.
Examining potential moderators and mediators will be key to understanding what works best for whom.
Importantly, impulsivity reductions were primarily assessed at immediate post-treatment – whether these effects persist long-term is uncertain based on the lack of follow-up data.
Despite the limitations, this review spotlights mindfulness as a promising approach warranting further investigation as a targeted treatment for impulsivity.
The appeal lies in its potential cost-effectiveness and portability to be implemented across diverse real-world contexts. Ascertaining the independent value of mindfulness, separate from its incorporation in broader treatment protocols, is an important scientific endeavor.
Future research should utilize randomized controlled designs, larger samples, multiple measurement modalities, and longer-term follow-up to establish mindfulness as an empirically-validated stand-alone treatment for impulsivity.
Strengths
This review has several strengths, including:
Limitations
This review also had several limitations, including:
The inconsistencies and limitations across studies constrain the strength of the conclusions that can be made about mindfulness as a stand-alone treatment for impulsivity at this stage. Caution is warranted in overgeneralizing these preliminary findings.
Implications
While still an emerging area of study, this review suggests mindfulness could potentially serve as a cost-effective, accessible intervention to reduce the substantial personal and societal toll of impulsivity.
With further empirical validation, stand-alone mindfulness treatments could be an important addition to clinicians’ toolkits.
However, much work remains to translate these preliminary findings into real-world impact. Mindfulness protocols need to be standardized and rigorously tested against well-defined control conditions.
Understanding what specific components of mindfulness are most active in reducing impulsivity will enable treatment optimization. Clarifying the populations and contexts for which mindfulness is maximally beneficial will guide appropriate implementation.
The fact that impulsivity is a cross-cutting construct implicated across diverse clinical conditions underscores the importance of developing targeted, transdiagnostic interventions.
By directing attention and awareness in ways that enable greater self-regulation, mindfulness may disrupt maladaptive impulsive response patterns.
With robust supporting evidence, stand-alonemindfulness could become a first-line treatment recommendation for impulsivity in conditions such as ADHDthat promotes meaningful change for individuals and society at large.
The vital next step is leveraging the insights from this review to design high-quality studies that definitively establish mindfulness as an effective, evidence-based intervention for impulsivity.
References
Primary reference
Aksen, D. E., Sleight, F. G., & Lynn, S. J. (2023). Mindfulness intervention for impulsivity as a stand-alone treatment: A qualitative review of emerging evidence.Psychology of Consciousness: Theory, Research, and Practice.Advance online publication.https://doi.org/10.1037/cns0000367
Other references
American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders(5th ed., text rev.).https://doi.org/10.1176/appi.books.9780890425787
Beauchaine, T. P., & Neuhaus, E. (2008). Impulsivity and vulnerability to psychopathology. In T. P. Beauchaine & S. P. Hinshaw (Eds.),Child and adolescent psychopathology(pp. 129–156). Wiley.
Chamorro, J., Bernardi, S., Potenza, M. N., Grant, J. E., Marsh, R., Wang, S., & Blanco, C. (2012). Impulsivity in the general population: A national study.Journal of Psychiatric Research, 46(8), 994–1001.https://doi.org/10.1016/j.jpsychires.2012.04.023
Linehan, M. M. (1987). Dialectical behavior therapy for borderline personality disorder: Theory and method.Bulletin of the Menninger Clinic,51(3), 261–276.
Murphy, C., & Mackillop, J. (2012). Living in the here and now: Interrelationships between impulsivity, mindfulness, and alcohol misuse.Psychopharmacology, 219(2), 527–536.https://doi.org/10.1007/s00213-011-2573-0
Orwin, R. G. (1994). Evaluating coding decisions. In H. Cooper & L. V. Hedges (Eds.),The handbook of research synthesis(pp. 139–162). Sage Publications.
Palili, A., Kolaitis, G., Vassi, I., Veltsista, A., Bakoula, C., & Gika, A. (2011). Inattention, hyperactivity, impulsivity—Epidemiology and correlations: A nationwide Greek study from birth to 18 years.Journal of Child Neurology, 26(2), 199–204.https://doi.org/10.1177/0883073810379640
Keep Learning
Below are some potential Socratic questions for class discussion of this paper:
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
